. 2014 Dec 22;10(6):1191–1197. doi: 10.5114/aoms.2014.47829

Table II.

Comparison between DSM-IV and DSM-5 alcohol-related disorders

DSM-IV	DSM-5
Dependence criteria: A maladaptive pattern of drinking, leading to clinically significant impairment or distress as manifested by three or more of the following seven symptoms occurring in the same 12-month period: Tolerance: need for markedly increased amounts of alcohol to achieve intoxication or desired effect; or markedly diminished effect with continued use of the same amount of alcohol. The characteristic withdrawal syndrome for alcohol (or a closely related substance) or drinking to relieve or avoid withdrawal symptoms. Persistent desire or one or more unsuccessful efforts to cut down or control drinking. Drinking in larger amounts or over a longer period than the person intended. Important social, occupational, or recreational activities given up or reduced because of drinking. A great deal of time spent in activities necessary to obtain, to use or to recover from the effects of drinking. Continued drinking despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to be caused or exacerbated by drinking. Abuse/harmful use criteria: Criteria for alcohol dependence have never been met. A maladaptive pattern of drinking, leading to clinically significant impairment or distress as manifested by at least one of the following four symptoms occurring within a 12-month period: Recurrent use of alcohol resulting in a failure to fulfil major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to alcohol use; alcohol-related absences, suspensions, or expulsions from school; neglect of children or household). Recurrent alcohol use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by alcohol use). Recurrent alcohol-related legal problems (e.g., arrests for alcohol-related disorderly conduct). Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of alcohol (e.g., arguments with spouse about consequences of intoxication).	A maladaptive pattern of drinking, leading to clinically significant impairment or distress as manifested by at least two of the following symptoms occurring in the same 12-month period: Alcohol is often taken in larger amounts or over a longer period than was intended. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. Craving, or a strong desire or urge to use alcohol. Recurrent alcohol use resulting in a failure to fulfil major role obligations at work, school, or home. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol. Important social, occupational, or recreational activities are given up or reduced because of alcohol use. Recurrent alcohol use in situations in which it is physically hazardous. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol. Tolerance, as defined by either of the following: A need for markedly increased amounts of alcohol to achieve intoxication or the desired effect. A markedly diminished effect with continued use of the same amount of alcohol. Withdrawal, as manifested by either of the following: The characteristic withdrawal syndrome for alcohol. Alcohol (or closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

DSM-IV

DSM-5

Dependence criteria:
A maladaptive pattern of drinking, leading to clinically significant impairment or distress as manifested by three or more of the following seven symptoms occurring in the same 12-month period:

Tolerance: need for markedly increased amounts of alcohol to achieve intoxication or desired effect; or markedly diminished effect with continued use of the same amount of alcohol.
The characteristic withdrawal syndrome for alcohol (or a closely related substance) or drinking to relieve or avoid withdrawal symptoms.
Persistent desire or one or more unsuccessful efforts to cut down or control drinking.
Drinking in larger amounts or over a longer period than the person intended.
Important social, occupational, or recreational activities given up or reduced because of drinking.
A great deal of time spent in activities necessary to obtain, to use or to recover from the effects of drinking.
Continued drinking despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to be caused or exacerbated by drinking.

Abuse/harmful use criteria:

Criteria for alcohol dependence have never been met.
A maladaptive pattern of drinking, leading to clinically significant impairment or distress as manifested by at least one of the following four symptoms occurring within a 12-month period:
1. Recurrent use of alcohol resulting in a failure to fulfil major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to alcohol use; alcohol-related absences, suspensions, or expulsions from school; neglect of children or household).
2. Recurrent alcohol use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by alcohol use).
3. Recurrent alcohol-related legal problems (e.g., arrests for alcohol-related disorderly conduct).
4. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of alcohol (e.g., arguments with spouse about consequences of intoxication).

A maladaptive pattern of drinking, leading to clinically significant impairment or distress as manifested by at least two of the following symptoms occurring in the same 12-month period:
1. Alcohol is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
4. Craving, or a strong desire or urge to use alcohol.
5. Recurrent alcohol use resulting in a failure to fulfil major role obligations at work, school, or home.
6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
8. Recurrent alcohol use in situations in which it is physically hazardous.
9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
10. Tolerance, as defined by either of the following:
  1. A need for markedly increased amounts of alcohol to achieve intoxication or the desired effect.
  2. A markedly diminished effect with continued use of the same amount of alcohol.
11. Withdrawal, as manifested by either of the following:
  1. The characteristic withdrawal syndrome for alcohol.
  2. Alcohol (or closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.